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Last Updated: Tuesday, 12 September 2006, 07:19 GMT 08:19 UK
Public health plans 'in disarray'
By Nick Triggle
BBC News, health reporter

Overweight men
Projects to tackle obesity have been scrapped
Measures to tackle rising public health problems are being scrapped or postponed because the funds have not materialised, public health chiefs say.

An extra 211m was to be ploughed into projects in England this year to tackle smoking, obesity and sexual health.

But public health directors say just a fraction was coming through because of the deficits crisis and the push risked "never getting off the ground".

The government says NHS trusts should be making public health a priority.

Meanwhile, a group of 110 childhood experts has written to the Daily Telegraph newspaper warning that a lifestyle dominated by junk food, marketing, over-competitive education and screen-based entertainment is adversely affecting children's behaviour and development.

White paper

The Public Health White Paper, Choosing Health?, published two years ago, is best known for proposing the smoking ban but also included a range of measures to tackle other problems.

It is so disheartening. Two years ago we thought we had reached a real turning point, now it is in disarray
Angela Mawle, of the Public Health Association

Primary care trusts (PCTs), which control local NHS budgets, responded by drawing up a number of plans involving health trainers, school nurses, dieticians and health psychologists.

Some 211m of extra funding to pay for the projects was due to kick in this year, with another 131m next.

But the Association of Directors of Public Health says the money is not reaching the public health budgets because it is being used to plug deficits instead.

A snapshot survey of 24 London PCTs revealed only 1 in 6 was ending up in public health budgets.

But the association said trusts across England were affected with some public health budgets not getting anything extra.

In Derbyshire, plans to employ more school nurses and health trainers, who give lifestyle and diet advice, have been shelved after public health bosses received less than a quarter of the 3m they expected.


While in Hillingdon, in London, the roll out of the chlamydia screening programme for 16 to 24-year-olds is on hold and a new system involving dieticians, psychologists and exercise referral for the overweight was scrapped.

None of the expected 767,000 extra this year has reached the public health budget.

And chlamydia screening and an obesity strategy have been put on hold in Wiltshire.

Association of Directors of Public Health president Dr Tim Crayford warned if the issue was not addressed the country could see public health problems soar.

"Public health funding is like the country's pension. It's easy to avoid paying your contributions in a tight financial year.

Primary care trusts, which are closest to their local patients, are best placed to assess local needs and to arrange services appropriately
Department of Health spokeswoman

"You won't generally notice any difference to your lifestyle in the year you have your 'pension holiday'.

"Twenty years later, however, the consequences of that one year will catch up with you."

He said while the government had showed a great commitment by earmarking this funding for public health, he wanted to see ministers go further by ring-fencing the money.

If not, the push on public health risked "never getting off the ground", he added.

Angela Mawle, chief executive of the Public Health Association campaign group added: "It is so disheartening. Two years ago we thought we had reached a real turning point, now it is in disarray."


Nigel Edwards, director of policy at the NHS Confederation, which represents health trusts, said PCTs were under pressure because the government had made achieving financial balance a "top priority".

The NHS is suffering from a severe bout of short-termism
Steve Webb
Liberal Democrats

He added there needed to be a separate funding pot for public health.

A Department of Health spokeswoman said public health was one of the NHS's priorities.

But she added: "The department does not generally ring-fence money because patients' needs are different in different local areas.

"Primary care trusts, which are closest to their local patients, are best placed to assess local needs and to arrange services appropriately."

Shadow Health Secretary Andrew Lansley said: "The government have failed to match their rhetoric on measures to tackle public health problems with the necessary structures on the ground.

"Public health budgets are being plundered in an effort to offset deficits created by the Government's financial mismanagement of the NHS.

"Public health budgets need to be ring-fenced to stop this and secure the long term strategies needed to deliver improved outcomes."

Steve Webb, for the Liberal Democrats, said: "The NHS is suffering from a severe bout of short-termism.

"Cuts are being made to balance the books at the expense of investment that could save billions in the future."

Head of the Association of the Directors of Public Health

A public health turning point?
20 Nov 04 |  Health

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